Over 2 million Ohioans face high out of pocket health care costs

For more than 2 million Ohioans, affordable health care remains out of reach.

In 2021, the families of roughly 1 in 5 people – or 2.2 million Ohioans – spent more than 10% of their annual household income on out-of-pocket health care costs. This is despite more people being insured in Ohio than over a decade ago: Ohio’s uninsured rate was halved between 2010 and 2022, falling from 14% to 7%.

The findings come from the latest report by the Health Policy Institute of Ohio, a nonpartisan research institute that tracks health in Ohio and compares it to other states. Ohio is ranked 44th state in the country, or near the bottom, according to the study, in terms of health value, a metric that combines health outcomes and health care spending.

This means that despite spending more on health care than people in other states, Ohioans are less healthy.

“We spend more than many other states on health care,” said Amy Rohling Mcgee, president of the Health Policy Institute of Ohio. “So we’re not getting good value there.”

Emergency department visits may increase health care spending in Ohio

The reasons behind Ohio’s high health care costs are complex, but a possible contributor is preventable emergency department visits.

The Health Policy Institute of Ohio found that even those with employerbased health insurance were opting for the emergency department instead of primary care or urgent care for medical attention.

In 2021, around 143 emergency room visits out of every 1,000 Ohioans with employer-provided insurance involved an issue that could have been handled by a regular doctor or waited more than 12 hours for treatment.

This ranked Ohio fifth from the bottom, out of the 49 states with available data. The high rate of preventable emergency department visits suggests that Ohioans might be delaying seeking care until their health issue worsens – and becomes more expensive to treat.

“Our hypothesis is that if people had access to primary care and a place to go before conditions worsened to the extent that they needed to go to the emergency department, then we would both have better health outcomes and lower health care spending,” Mcgee said. The federal government considers preventable emergency department visits to be a negative indicator, due to their high costs and the strain they cause to emergency departments that are typically set up to handle urgent, life-threatening situations. Mcgee suggests that while cost might play a role, barriers such as distance or physical access are likely bigger factors in decisions to go to a hospital emergency department.

“Preventive services have been free since the Affordable Care Act, so that is less of an issue than it used to be,” she said. “I think the bigger issue is not having places to go for that kind of care.” More than 40 of Ohio’s 88 counties face health professional shortages, according to the Ohio Department of Health, many of them in northeast Ohio. Hamilton, Butler, Warren, and Clermont counties were not considered to be experiencing shortages.